At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This position is responsible for receipt and coordination of CMS MA-PD and PDP escalated complaints; submission of member and marketing materials to CMS for HCSC’s Medicare Advantage and Prescription Drug Plans; applying CMS regulations pertaining to Medicare Advantage and Prescription Drug Plans to the review of member and marketing materials prior to submission to CMS; providing assistance and guidance regarding Medicare Advantage and Prescription Drug Plan regulations to HISC staff; working with other areas of the organization on the development, testing and implementation of organization, process and system changes to ensure the requirements of the Medicare Advantage and Prescription Drug program are met; and assisting MCO in coordination of the contract with CMS enterprise-wide.

JOB REQUIREMENTS:

• Bachelor’s degree in Business OR 2 years’ experience with health insurance.
• 1 year of experience with health insurance benefits and/or operations.
• Knowledge of Medicare advantage product.
• Verbal and written communication skills.
• Ability to present Medicare trends and findings in meetings with management.
• Ability to organize multiple tasks and responsibilities.
• Ability to analyze data reports.
• Experience developing and running queries in a database.
• PC proficiency to include Microsoft Word, Outlook, Excel and PowerPoint.

PREFERRED JOB REQUIREMENTS:

• Knowledge of CMS Medicare Advantage software applications
• Prescription Drug coverage and PPO knowledge including Regulations and Guidelines.
• Knowledge of health benefits
• Ability to affectively adapt and respond in a complex, fast-paced, high-volume environment.
• Ability to maintain positive/productive relationships and recommend solutions, if appropriate
• Ability to exercise administrative judgment and assumes responsibility for decisions, consequences, and results.
• Basic understanding of managed care and its place in the health care industry.
  

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Please refer the Job description for details